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HCPCS Level II/M-Codes/M1292

M1292 HCPCS Level II Code: Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period

Medicare Coverage & Payment

  • Medicare coverage: Carrier judgment (CMS coverage code C)
  • Payment category: Service not separately priced (pricing indicator 00)
  • BETOS: Z2
  • Effective: January 1, 2025

Source: CMS HCPCS Level II release. Coverage codes indicate how Medicare treats the code, not whether a specific claim will be paid; payer policy and documentation still govern.

Official Registry Overview & Definition

Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period is a HCPCS Level II code (M1292) for a Medicare-covered supply, service, or procedure. Short description: Pt 66+ frail inpt adv ill.

Nearest Codes in This Family

Official HCPCS Level II classifications closest to M1292 in its code family, with their registry titles.

  • M1287 — Bmi is documented below normal parameters and a follow-up plan is documented
  • M1288 — Documented reason for not screening or recommending a follow-up for high blood pressure
  • M1289 — Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)
  • M1290 — Patient not eligible due to active diagnosis of hypertension
  • M1291 — Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period
  • M1293 — Bmi is documented above normal parameters and a follow-up plan is documented
  • M1294 — Normal blood pressure reading documented, follow-up not required
  • M1295 — Patients with a diagnosis or past history of total colectomy or colorectal cancer
  • M1296 — Bmi is documented within normal parameters and no follow-up plan is required
  • M1297 — Bmi not documented due to medical reason or patient refusal of height or weight measurement